PT  - JOURNAL ARTICLE
AU  - Tsukasa Kamakura
AU  - Tetsuji Shinohara
AU  - Kenji Yodogawa
AU  - Nobuyuki Murakoshi
AU  - Hiroshi Morita
AU  - Naohiko Takahashi
AU  - Yasuya Inden
AU  - Wataru Shimizu
AU  - Akihiko Nogami
AU  - Minoru Horie
AU  - Takeshi Aiba
AU  - Kengo Kusano
TI  - Long-term prognosis of patients with J-wave syndrome
AID  - 10.1136/heartjnl-2019-315007
DP  - 2020 Feb 01
TA  - Heart
PG  - 299--306
VI  - 106
IP  - 4
4099  - http://heart.bmj.com/content/106/4/299.short
4100  - http://heart.bmj.com/content/106/4/299.full
SO  - Heart2020 Feb 01; 106
AB  - Objective Limited data are currently available regarding the long-term prognosis of patients with J-wave syndrome (JWS). The aim of this study was to investigate the long-term prognosis of patients with JWS and identify predictors of the recurrence of ventricular fibrillation (VF).Methods This was a multicentre retrospective study (seven Japanese hospitals) involving 134 patients with JWS (Brugada syndrome (BrS): 85; early repolarisation syndrome (ERS): 49) treated with an implantable cardioverter defibrillator. All patients had a history of VF. All patients with ERS underwent drug provocation testing with standard and high intercostal ECG recordings to rule out BrS. The impact of global J waves (type 1 ECG or anterior J waves and inferolateral J waves in two or more leads) on the prognosis was evaluated.Results During the 91±66 months of the follow-up period, 52 (39%) patients (BrS: 37; ERS: 15) experienced recurrence of VF. Patients with BrS and ERS with global J waves showed a significantly higher incidence of VF recurrence than those without (BrS: log-rank, p=0.014; ERS: log-rank, p=0.0009). The presence of global J waves was a predictor of VF recurrence in patients with JWS (HR: 2.16, 95% CI 1.21 to 3.91, p=0.0095), while previously reported high-risk electrocardiographic parameters (high-amplitude J waves ≥0.2 mV and J waves associated with a horizontal or descending ST segment) were not predictive of VF recurrence.Conclusions This multicentre long-term study showed that the presence of global J waves was associated with a higher incidence of VF recurrence in patients with JWS.